Fibroblast Growth Factor 23: Potential Marker of Invisible Heart Damage in Diabetic Population

Area of Science:

• Cardiology
• Endocrinology
• Biomarkers

Background:

• Two-dimensional speckle-tracking echocardiography (2DSTE) identifies myocardial dysfunction even with normal ejection fraction.
• Fibroblast growth factor 23 (FGF23) is an emerging cardiovascular risk biomarker.

Purpose of the Study:

• To investigate FGF23 as a potential biomarker for myocardial damage in type 2 diabetes mellitus (T2DM) patients without prior myocardial infarction.
• To correlate FGF23 levels with cardiac function assessed by 2DSTE.

Main Methods:

• Retrospective analysis of 71 T2DM patients (median age 70 years, median T2DM duration 19 years).
• Serum FGF23 measurement via ELISA.
• Conventional echocardiography and 2DSTE, including global circumferential strain (GCS).
• Patient stratification based on left ventricular diastolic function.

Main Results:

• Patients with diastolic dysfunction showed lower estimated glomerular filtration rate and higher hemoglobin A1c.
• Reduced global circumferential strain (GCS) was prevalent.
• Epicardial GCS significantly correlated with serum FGF23 levels across all patients.

Conclusions:

• Cardiac strain assessment using 2DSTE is a reliable method for detecting subclinical myocardial damage in T2DM.
• FGF23 may serve as an early diagnostic marker for myocardial injury in T2DM patients.